간아세포종 환아의 임상적 특성과 예후

김민영,김대연,안효섭,김종재,김인원,정성은,이성철,박귀원,김우기,Kim, Min-Young,Kim, Dae-Yeon,Ahn, Hyo-Seep,Kim, Chong-Jai,Kim, In-One,Jung, Sung-Eun,Lee, Seong-Cheol,Park, Kwi-Won,Kim, Woo-Ki 대한소아외과학회 1997 소아외과 Vol.3 No.2

Hepatoblastoma is a rare pediatric malignancy which frequently presents at an advanced un resectable stage. With the neoadjuvant chemotherapy, improved resectability and survival have been reported. Twenty children with biopsy proven hepatoblastoma were treated during the period between January 1987 and June 1995. Median age at diagnosis was 13 months(2 months to 7 year and 10 months), and 13 were male. Histologic profile was 13 epithelial(5 fetal, 4 mixed, 1 embryonal, 3 undetermined), and 5 mixed mesenchymal and epithelial and 2 of undetermined type. Chemotherapy effectively reduced the tumor volume($p$=0.008), and was able to convert 7 out of 9 initially unresectable cases(78%) to resectable ones. Twelve radical and 2 palliative operations were done with or without adjuvant chemotherapy. The Median follow up period was 33 months and the median survival was 26 months. The group with curative resection had a 61.1% 5 year survival rate, but none of palliative resection group survived more than 13 months($p$=0.0001). In univariate analysis for prognostic factors revealed, large tumor size at diagnosis and abscence of thrombocytopenia were associated with poor survival, but these differences were not statistically significant. Histological pure fetal type did not mean a better prognosis. Even with a recent neoadjuvant chemotherapy, the strategy should be focused on the radical resection as early as possible.

Transcriptional activation of hypoxia-inducible factor-1 (HIF-1) in myeloid cells promotes angiogenesis through VEGF and S100A8

Ahn, G-One,Seita, Jun,Hong, Beom-Ju,Kim, Young-Eun,Bok, Seoyeon,Lee, Chan-Ju,Kim, Kwang Soon,Lee, Jerry C.,Leeper, Nicholas J.,Cooke, John P.,Kim, Hak Jae,Kim, Il Han,Weissman, Irving L.,Brown, J. Mar National Academy of Sciences 2014 PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF Vol.111 No.7

<P>Emerging evidence indicates that myeloid cells are essential for promoting new blood vessel formation by secreting various angiogenic factors. Given that hypoxia-inducible factor (HIF) is a critical regulator for angiogenesis, we questioned whether HIF in myeloid cells also plays a role in promoting angiogenesis. To address this question, we generated a unique strain of myeloid-specific knockout mice targeting HIF pathways using human S100A8 as a myeloid-specific promoter. We observed that mutant mice where HIF-1 is transcriptionally activated in myeloid cells (by deletion of the von Hippel–Lindau gene) resulted in erythema, enhanced neovascularization in matrigel plugs, and increased production of vascular endothelial growth factor (VEGF) in the bone marrow, all of which were completely abrogated by either genetic or pharmacological inactivation of HIF-1. We further found that monocytes were the major effector producing VEGF and S100A8 proteins driving neovascularization in matrigel. Moreover, by using a mouse model of hindlimb ischemia we observed significantly improved blood flow in mice intramuscularly injected with HIF-1–activated monocytes. This study therefore demonstrates that HIF-1 activation in myeloid cells promotes angiogenesis through VEGF and S100A8 and that this may become an attractive therapeutic strategy to treat diseases with vascular defects.</P>

Novel role of tumor-associated macrophages in modulating tumor metabolism

G ONE AHN(안지완) 한국실험동물학회 2020 한국실험동물학회 학술발표대회 논문집 Vol.2020 No.7

Effect of filler etching on adhesion between metal seed layer and polymer

Key-one Ahn,Jianyang Sun,Se-Hoon Park,Young-Ho Kim 한국생산제조학회 2012 한국생산제조시스템학회 학술발표대회 논문집 Vol.2012 No.10

Case Reports : A Case of a Subepidermal Calcified Nodule on the Sole without Trauma

( In Su Ahn ),( Bo Young Chung ),( Hee Bong Lee ),( Hye One Kim ),( Hye Kyoung Ahn ),( Chun Wook Park ),( Cheol Heon Lee ) 대한피부과학회 2011 Annals of Dermatology Vol.23 No.1S

Subepidermal calcified nodule is an uncommon form of calcinosis cutis, which most commonly occurs in children. It usually presents as an asymptomatic, solitary verrucous nodule on the head and neck region, but occasionally as multiple lesions. Serum calcium and phosphorus levels are usually normal. Histopathology shows well-formed homogeneous eosinophilic material and granules in the upper dermis. Material in the dermis stained with von Kossa was positive. We report on an unusual case of a subepidermal calcified nodule occurring on the sole. A 21-month-old male presented with an oval-shaped, whitish, hard nodule measuring 5×5 mm on the left sole, without any previous history of trauma. (Ann Dermatol 23(S1) S116~S118, 2011)

보조생식술후 태아에서 발생한 de novo 염색체 이상

안기헌 ( Ki Heon Ahn ),이국원 ( Kook One Lee ),주종길 ( Jong Kil Joo ),신병섭 ( Byung Sup Shin ),최욱환 ( Ook Hwan Choi ) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.9

We experienced two cases of de novo fetal chromosomal abnormalities after assisted reproductive technology (ART): One case was reciprocal translocation 46,XX,t(6;14)(p21.3;q12) after intracytoplasmic sperm injection & embryo transfer (ICSI-ET) and the other case was 46,X,iso(Xq) after in vitro fertilization & embryo transfer (IVF-ET), both were diagnosed prenatally by amniocentesis and postnatally cord blood culture. We report these cases with a brief review of literatures.

왼쪽 다리에 발생한 낭종형 에크린 나선종

안인수 ( In Su Ahn ),정보영 ( Bo Young Chung ),이희봉 ( Hee Bong Lee ),최지훈 ( Ji Hoon Choi ),안혜경 ( Hye Kyoung Ahn ),김혜원 ( Hye One Kim ),박천욱 ( Chun Wook Park ),이철헌 ( Cheol Heon Lee ) 대한피부과학회 2010 대한피부과학회지 Vol.48 No.5

Eccrine spiradenoma is a benign tumor that is differentiated into the direction of an eccrine gland. It is usually presents as a solitary, slowly-growing, intradermal or deeply subcutaneous nodule on the head and trunk. We report on a case of 32-year-old woman with a solitary, solid mass on the left leg that she`d had for 6 months. The mass was a 2.5×2×0.5 cm sized, round shaped, well demarcated solitary skin-colored nodule. The mass in our case was a relatively large and painful eccrine spiradenoma, and the mass showed cystic formation. The cyst was surrounded by cords of tumor cells. Hyaline materials were seen focally. There were two types of cells. Large pale nuclei existed adjacent to the cyst. Small dark nuclei existed at the periphery. To clarify the histogenesis of this tumor, immunohistochemical staining using various antibodies was also performed. We herein report on an unusual case of a large cystic eccrine spiradenoma. (Korean J Dermatol 2010;48(5):409~412)

비소세포성 폐암에서 3차원 입체조형 방사선 치료 성적

최은경(Eun Kyung Choi),이병용(Byong Yong Yi),강원철(One Chul Kang),노영주(Young Ju Nho),정원규(Weon Kuu Chung),안승도(Seung Do Ahn),김종훈(Jong Hoon Kim),장혜숙(Hyesook Chang) 대한방사선종양학회 1998 Radiation Oncology Journal Vol.16 No.3

목 적 : 비소세포성 폐암에서 새로운 치료방법으로 대두되고 있는 3차원 입체조형 방사선 치료(Three dimensional conformal radiotherapy, 3DCRT)의 임상적용 가능성과 기존의 치료법에 비한 장점을 찾고자 1994년부터 전향적 연구를 시행하였다. 본 연구는 1) 가장 효과적인 3차원 입체조형 치료 방법의 개발, 2) 가능한 총 치료 선량증가, 3) 선량 증가에 따른 방사선 폐렴 발생 위험군 예측, 4) 선량증가에 따른 국소관해 및 생존율 향상을 목적으로 하였다. 대상 및 방 법 : 1996년 12월까지 수술이 불가능하다고 판정된 95명의 환자(stage I ; 4명, stage II ; 1명, stage IIIa ; 14명, stage IIIb ; 76명)에 대하여 3차원 입체조형 치료를 시행하였다. 3차원 입체조형 치료를 위하여 고정기구를 이용하여 앙와위 혹은 복와위 상태로 자세를 고정한 다음 CT-simulator를 이용하여 5mm간격으로 CT 영상을 얻고 GTV(Gross Tumor Volume), CTV(Clinical Target Volume), PTV(Planning Target Volume)를 정한 후 3차원 치료계획용 컴퓨터를 이용하여 치료계획을 세웠다. 방사선 치료는 육안적 종양과 림프절을 포함하는 부위에 36∼40 Gy 를 AP-PA로 치료한 후 25∼34 Gy의 3차원 입체조형 치료를 추가조사하여 총 65∼70 Gy 를 시행하였다. 이중 78명(82.1%)의 환자는 2회의 MVP(Mitomycin C, Vinblastine, Cisplatin) 복합항암요법을 동시에 시행하였다. 3차원 입체조형 치료 계획은 1) 표적 부위의 3차원 선량분포, 2) DVH (Dose Volume Histogram), 3) NTCP (Normal Tissue Complication Probability)를 이용하여 기존의 2차원 통상 치료 계획과 비교하였다. 결과 : 78명의 환자에서는 4∼8 조사영역을 이용하는 비동일 평면 입체조형 치료(Non-coplanar 3DCRT) 방법을 사용하였으며 17명에서는 Coplanar segmented 3DCRT 방법으로 치료하였다. 거의 모든 환자에서 표적부위에 100%의 선량 조사가 가능하였으며 심장에 대한 Dose volume histogram 분석결과 좌폐하엽 부위 종양 치료시에는 특히 3차원 입체조형 치료가 심장 선량을 줄여줌을 알 수 있었다. 3차원 입체조형 치료에 의한 동측폐의 NTCP 평균값은 0.26(0.17∼0.43)으로 2차원 통상 치료의 NTCP 평균값 0.38(0.2-0.66)에 비하여 부작용이 생길 확률이 32% 줄어들었다. 치료 결과는 26%(25/95)의 환자에서 완전관해를 보였으며 53%(50/95)에서는 부분관해를 보여 전체 79%의 환자에서 부분관해 이상의 반응을 보였다. 1기와 2기 환자 5명을 제외한 3기 환자 90명의 1년과 2년 생존율은 62.6% 와 35.2%로 같은 기간에 2차원 통상치료로 치료받은 환자의 1년과 2년 생존율 51.9% 와 26.8%에 비하여 다소 증가 되었으나 통계적으로 유의한 차이를 보이지는 않았다. 치료후 19명(Grade 1 : 8, Grade 2 : 11)의 환자에서 방사선 폐렴이 발생하였으나 steroid 치료후 모두 호전되었으며 치료 후 발생하는 방사선 폐렴을 예측할 수 있는 가장 좋은 지표는 동측폐에 대한 NTCP 값이었다(35% vs 22%). 결 론 : 이상의 결과 폐암에 대한 3차원 입체조형 방사선 치료는 기존의 치료법에 비하여 부작용의 증가 없이 총 방사선량을 증가시킬 수 있는 좋은 방법으로 생각되며 방사선 폐렴의 예측인자로는 동측폐에 대한 NTCP 값이 매우 유용한 것으로 보여진다. 향후 NTCP 값에 따른 선량증가 연구와 이에 따른 생존율의 증가에 대한 연구가 더 진행되어야 할 것이다. Purpose : This prospective study has been conducted to assess the value of three dimensional conformal radiation therapy(3DCRT) for lung cancer and to determine its potential advantage over current treatment approaches. Specific aim of this study were to 1) find the most ideal 3DCRT technique 2) establish the maximum tolerance dose that can be delivered with 3DCRT and 3) identify patients at risk for development of radiation pneumonitis Materials and Methods : Beginning in Nov. 1994, 95 patients with inoperable non-small cell lung cancer (stage I; 4, stage II; 1, stage IIIa; 14, stage IIIb; 76) were entered onto this 3D conformal trial. Areas of known disease and elective nodal areas were initially treated to 45 Gy and then using 3DCRT technique 65 to 70 Gy of total dose were delivered to the gross disease. Sixty nine patients received 65 Gy of total dose and 26 received 70 Gy. Seventy eight patients(82.1%) also received concurrent MVP chemotherapy. 3DCRT plans were compared with 2D plans to assess the adequacy of dose delivery to target volume, dose volume histograms for normal tissue, and normal tissue c omplication probabilities (NTCP). Results : Most of plans (78/95) were composed of non-coplanar multiple (4-8) fields. Coplanar segmented conformal therapy was used in 17 pateints, choosing the proper gantry angle which minimize normal lung exposure in each segment. 3DCRT gave the full dose to nearly 100% of the gross disease target volume in all patients. The mean NTCP for ipsilateral lung with 3DCRT (range ; 0.17-0.43) was 68% of the mean NTCP with 2D treatment planning (range ; 0.27-0.66). DVH analysis for heart showed that irradiated volume of heart could be significantly reduced by non-coplanar 3D approach especially in the case of left lower lobe lesion. Of 95 patients evaluable for response, 75(79%), showed major response including 25(26%) with complete responses and 50(53%) with partial responses. One and two year overall survivals of stage Ⅲ patients were 62.6% and 35.2% respectively. Twenty percent (19/95) of patients had pneumonitis ; Eight patients had grade 1 pneumonitis and 11 other patients had grade 2. Comparison of the average of NTCP for lung showed a significant difference between patients with and without radiation pneumonitis. Average NTCP for patients without complication was 62% of those with complications. Conclusions : This study showed that non-coplanar multiple fields (4-8) may be one of the ideal plans for 3DCRT for lung cancer. It also suggested that 3DCRT may provide superior delivery of high dose radiation with reduced risk to normal tissue and that NTCP can be used as a guideline for the dose escalation.

비인두강 종양의 방사선치료성적

노영주(Young Ju Nho),조정길(Jeong Gill Cho),안승도(Seung Do Ahn),최은경(Eun Kyung Choi),김종훈(Jong Hoon Kim),강원철(One Chul Kang),장혜숙(Hyesook Chang) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.4

목 적 : 비인두강종양의 방사선치료의 결과를 후향적으로 분석하여 방사선치료의 효과와 예후인자를 분석하고자 하였다. 대상 및 방법 : 1989년부터 1996년까지 서울중앙병원에서 비인두강종양으로 진단받고 근치적 방사선치료를 시행한 56명을 대상으로 하였다. 병기별로 보면 T1, T2, T3, T4가 각각 17, 10, 11, 18명이었고 N0, N1, N2, N3가 각각 11명, 27명, 4명, 14명이었다. 근치적 방사선치료만 시행한 환자는 28명, 유도항암요법을 병용한 환자는 7명, 매주 CDDP 항암요법을 병용한 환자는 21명이었다. 조사량은 6940-8620cGy였고 중앙값은 7440cGy였다. 외부방사선조사 60Gy이후 원발병소에 대한 부가적치료는 1명은 외부방사선조사, 46명은 강내조사, 9명은 삼차원 입체조형치료를 받았다. 추적관찰기간은 5-92개월이었고 중앙값은 34개월이었다. 결 과 : 전치료후 47명은 완전관해, 8명은 부분관해, 1명은 무반응을 보였다. 5년 생존율은 67.2%, 5년 무병생존율은 53.6%이였다. 국소재발이 생긴 시기는 6-45개월(중앙값 : 14개월)이었으며 전신적 전이가 생긴 시기는 3-49개월(중앙값 : 16개월)이었다. 8명의 환자(14.3%)에서 국소재발이 발생하였고 18명의 환자(32.1%)에서 전신적 전이가 발생하였다. T3나 T4 환자 중 강내조사를 받은 20명중 4명(20%)에서 원발병소에 재발이 있었고 삼차원 입체조형치료를 받은 9명 중 1명(11%)에서 원발병소에 재발이 발생하였다. 전신적 전이는 골전이가 가장 많았다. 생존율에 영향을 주는 예후인자로는 생존율에는 KPS( P=0.005), 방사선치료에 대한 반응(P=0.0001)이 통계학적으로 유의하였고 무병생존율에는 KPS(P=0.02), 방사선치료에 대한 반응(P=0.005)이 통계학적으로 유의하였다. 국소재발과 관련있는 예후인자는 없었으며 원격전이와 관련있는 예후인자는 N stage(P=0.06), 병기(P=0.06)가 다소 의미있는 경향을 보였고, 방사선치료에 대한 반 응(P=0.009)이 통계학적으로 유의하였다. 결 론 : 비인두강종양에서 방사선치료로 5년생존율 67.2%이었고 5년 무병생존율은 53.6%이였다. 재발양상을 보면 국소재발보다는 전신적 전이율이 높음을 알 수 있었고 항암치료와의 병용은 관련이 없었다. T3 혹은 T4 병기에서 삼차원 입체조형치료를 받은 환자에 대해서는 앞으로 추적관찰이 좀더 필요할 것으로 생각된다. 앞으로 국소관해를 높이기 위한 방사선치료방법과 전신적 전이율의 감소를 위한 항암요법에 관한 연구가 필요할 것으로 생각된다. Purpose : This is a retrospective study to evaluate the results of radiation therapy and prognostic factors influencing the results in nasopharyngeal carcinoma. Materials and Methods : From October 1989 to May 1996, 56 patients were treated for nasopharyngeal carcinoma at Department of Radiation Oncology. According to stage, patients were distributed as follows : stage I (2), II (13), III (11), IV (30). Twenty-eight patients were treated with radiation therapy only, 7 patients were treated with neoadjuvant chemotherapy followed by radiation therapy. Twenty-one patients were treated with radiation therapy and weekly CDDP. After external beam radiotherapy of 60Gy, 46 patients received boost dose with intracavitary radiation and 9 patients with 3D conformal therapy. One patient received boost dose with 2 dimensional photon beam therapy. The tumor dose ranged from 69.4Gy to 86.2Gy with median dose of 74.4Gy. The follow -up period ranged from 5 months to 92 months with a median of 34 months. Results : Forty-seven patients achieved complete response and 8 patients showed partial response. One patient showed minimal response. Patterns of failure were as follows : locoregional recurrence (8) and distant metastasis (18). Among these patients, 2 patients failed locoregionally and distantly. The sites of distant metastasis were bone (8), lung (8) and liver (4). Five years survival rate was 67.2% and 5 years disease-free survival rate was 53.6%. KPS (P=0.005) and response of radiation therapy (P=0.0001) were significant prognostic factors for overall survival. KPS (P=0.02) and response of radiation therapy (P=0.005) were significant prognostic factors for disease-free survival. Conclusion : This retrospective study showed that distant metastasis was the predominant pattern of relapse in nasopharyngeal cancer. Neoadjuvant chemotherapy or weekly CDDP did not influence the distant metastasis-free survival. For advanced T stage, 3D conformal therapy provided an improved dose coverage compared to ICR. But further follow -up was needed in patients with 3D conformal therapy to assess the efficacy of this therapy. Development of techniques of radiation therapy to improve locoregional control and of more effective systemic chemotherapy regimen are needed.

Hemorrhagic moyamoya disease in children: clinical features and surgical outcome.

Ahn, Jun Hyong,Wang, Kyu-Chang,Phi, Ji Hoon,Lee, Ji Yeoun,Cho, Byung-Kyu,Kim, In-One,Kim, Seung-Ki Springer Verlag 2012 Child's nervous system Vol.28 No.2

<P>The clinical presentation of moyamoya disease (MMD) typically includes cerebral ischemia in children and intracranial hemorrhage in adults. Because of its rarity, the benefit of surgery in the hemorrhagic type of pediatric MMD has not been clearly established. The purpose of this study was to delineate the clinical features and surgical outcome of hemorrhagic MMD in children.</P>